2015 Census Test

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form dd-1_15_121014_d7 dd-1_15_121014_d7	Form	New	Available
Form dd-1a(es)_15_12101 dd-1a(es)_15_121014_d8	Form	New	Available
Form dd-1_15_121014_d7 dd-1_15_121014_d7	Form	New	Available
omb83-i for 2015 Census Test.pdf	Supplementary Document	Uploaded 2015-02-12	Available
Letter&Info_Flyer 102214.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd3309_no_line.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd92aes_20141211.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd33u_com_20141211.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd33a_com_20141211.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd33_11_17_docu_20141210.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd31_Draft 2_20141022.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd26b_Vietnamese_url.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd26b_Korean_url.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd26b_Chinese_url.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd26a_20141212.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd17l3_p1_20150120_Cropped.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd17l_1esp1_cropped_20150121.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd17l1_p1_20150120_Cropped.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd16l2_20150123.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd16l1es_20150123.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd16l1_20150123.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd9u_20141211.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd9reg_20141211.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd9es_20141211.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd9_20141211.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd9_2d_20141211.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd9_2a_20141211.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd8a_20141021.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd8a es_20141021.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd6a1ines_20141022.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd6ain_Draft 1_20140829.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd6a1ines_20141022.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd6a1in_Draft 1_20140829.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd5l_2015b_20141215.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd5l_2015_p1_doc_20150121.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd-1a(es)_15_121014_d8.pdf	Supplementary Document	Uploaded 2015-02-12	Available
dd-1_15_121014_d7.pdf	Supplementary Document	Uploaded 2015-02-12	Available
2015 Census Test -Wording of emails and texts 2-6-2015.docx	Supplementary Document	Uploaded 2015-02-12	Available
2015 Census Test COMPASS Questions Wording for OMB submission 10242014.docx	Supplementary Document	Uploaded 2015-02-12	Available
Letter&Info_Flyer 102214.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd3309_no_line.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd92aes_20141211.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd33u_com_20141211.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd33a_com_20141211.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd33_11_17_docu_20141210.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd31_Draft 2_20141022.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd26b_Vietnamese_url.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd26b_Korean_url.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd26b_Chinese_url.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd26b_20141212.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd26a_20141212.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd17l3_p1_20150120_Cropped.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd17l1_p1_20150120_Cropped.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd17l_1esp1_cropped_20150121.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd16l2__signed_20150116.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd16l1es_signed_20150115.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd16l1_signed_20150115.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd9u_20141211.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd9reg_20141211.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd9es_20141211.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd9_20141211.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd9_2d_20141211.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd9_2a_20141211.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd8a_20141021.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd8a es_20141021.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd6aines_20141022.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd6ain_Draft 1_20140829.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd6a1ines_20141022.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd6a1in_Draft 1_20140829.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd5l_2015b_20141215.pdf	Supplementary Document	Uploaded 2015-01-30	Available
dd5l_2015_p1_doc_20150121.pdf	Supplementary Document	Uploaded 2015-01-30	Available
BC-1325 as rec'd from NPC.pdf	Supplementary Document	Uploaded 2015-01-30	Available
2015 Census Test -Wording of emails and texts 2014-10-17.docx	Supplementary Document	Uploaded 2015-01-30	Available
2015_Census_Test_OMB_Part_B Final.docx	Supporting Statement B	Uploaded 2015-02-12	Available
2015_Census_Test_OMB_Part A Final.docx	Supporting Statement A	Uploaded 2015-02-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214823	Maricopa County - BYOD Follow Up	Other-	New
214822	Maricopa County - Focus Groups	Other-	New
214821	Maricopa County - Focus Groups Selection	Other-	New
214820	Maricopa County - Evaluation Follow Up	Other-	New
214819	Maricopa County - NonResponse Follow Up	Other-	New
214818	Maricopa County - Self Response	Form	New	dd-1_15_121014_d7
214818	Maricopa County - Self Response	Other-	New
214817	Savannah - Focus Groups	Other-	New
214816	Savannah - Focus Groups Selection	Other-	New
214810	Savannah - "Notify Me"	Other-	New
214809	Savannah - Self-Response Enumeration	Form	New	dd-1a(es)_15_121014_d8
214809	Savannah - Self-Response Enumeration	Form	New	dd-1_15_121014_d7
214809	Savannah - Self-Response Enumeration	Other-	New

ICR Details

OMB Control No: 0607-0981	ICR Reference No: 201412-0607-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOC/CENSUS	Agency Tracking No:
Title: 2015 Census Test
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/17/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/30/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2016	03/31/2016
Responses	575,448	0	0
Time Burden (Hours)	98,084	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The 2015 Census Test is needed to help find ways to reduce cost, increase self-response, and leverage new data collection alternatives while maintaining high quality results. The results of the 2015 Census Test will help guide the design of additional 2020 Census testing later this decade. The collection of data targets households and individuals.

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Authorizing Statute(s): US Code: 13 USC Section 141&193
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 51948	09/02/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 51948	01/13/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
Maricopa County - BYOD Follow Up
Maricopa County - Evaluation Follow Up
Maricopa County - Focus Groups
Maricopa County - Focus Groups Selection
Maricopa County - NonResponse Follow Up
Maricopa County - Self Response	dd-1_15_121014_d7	dd-1_15_121014_d7
Savannah - "Notify Me"
Savannah - Focus Groups
Savannah - Focus Groups Selection
Savannah - Self-Response Enumeration	dd-1_15_121014_d7, dd-1a(es)_15_121014_d8	dd-1_15_121014_d7 ,   dd-1a(es)_15_121014_d8

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	575,448	0	0	575,448	0	0
Annual Time Burden (Hours)	98,084	0	0	98,084	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: New Collection

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Annual Cost to Federal Government: $17,900,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/30/2015

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